Is It Okay To Get Botox While Pregnant?

Most people know they shouldn't drink alcohol, do drugs, or smoke during pregnancy. A couple of other things to keep in mind are avoiding certain foods like raw meat, uncooked seafood, and shellfish and checking with your doctor before taking medications (via Healthline). In addition to making lifestyle changes regarding your diet and exercise, you also need to make changes in your skincare routine. 

On this, Dr. Anjali Mahto, a consultant dermatologist, told Women's Health, "Certain active cosmetic ingredients may be absorbed through the skin during pregnancy." Dr. Mahto added that ingredients could get into your bloodstream, get to the baby through the placenta, and then affect its development. One skincare ingredient you probably use often that shouldn't be used during pregnancy is retinoids because there have been some cases of "retinoid-caused embryopathy [a developmental abnormality of an embryo or fetus]," per Women's Health. Instead of retinoids, you can still use peptides or Alpha-Hydroxy Acids like lactic acid, which are considered pregnancy-safe.

It's also essential to protect your skin from the sun during this time. What to Expect recommends using a mineral or physical sunscreen with zinc oxide or titanium dioxide instead of a chemical sunscreen that is absorbed by the skin. Physical sunscreens stay on the skin's surface while providing protection and are safer. If you're used to getting in-office treatments with a dermatologist, you also need to know if they can be continued during this time, and one of them is Botox. So, can you get Botox during pregnancy?

Here's what dermatologists say about using Botox during pregnancy

We've heard that Botox helps fight wrinkles, but how does it actually work? To explain this, Los Angeles–based dermatologist Harold Lancer told Allure, "Botox is an injectable neuromodulator that works to relax nerve-muscle imbalance." It works by temporarily paralyzing the muscles and stopping them from moving, which results in fewer or no wrinkles in the area.

While Botox is FDA-approved to treat lines on your forehead and around your eyes, it's also called a neurotoxin as it's made from the Clostridium botulinum-derived botulinum toxin (via Verywell Family). Jennifer Levine, a double board-certified plastic surgeon in NYC, told the outlet, "Botulinum toxin falls into a pregnancy category called 'X,' which means it's not safe to use during pregnancy." It might make sense to use Botox for cosmetic purposes, but when the risks to your unborn baby outweigh the benefits of fewer facial lines, it might be best to avoid it.

Most dermatologists don't recommend Botox during pregnancy. Manhattan-based and board-certified dermatologist Dendy Engelman told Byrdie, "There have not been sufficient studies done on this subject, and it's almost certain there will never be," because it's still unclear how it might affect the baby. Dr. Engelman added that most pregnant people wouldn't participate in a study where they would have to put their baby at potential risk, and that makes complete sense. It might be a time to do what's best for the baby's health and not take unnecessary risks.

Botox falls under FDA Category C drug during pregnancy

According to Botox Cosmetic, Botox was FDA-approved in 2002 and has been very popular because it can successfully treat "moderate to severe forehead lines, frown lines, and crow's feet in adult patients."

In 1979, the FDA had five letter risk categories (A, B, C, D, and X) to show how a drug could possibly affect the fetus during pregnancy, and it was updated in 2015, per Category A shows enough studies that a drug will not harm the developing baby. Category X, then, shows proof that using these drugs can result in "fetal abnormalities" and are therefore not recommended for use during pregnancy. The drugs that fall under category C showed "an adverse effect on the fetus" on animals but didn't yet have enough studies on humans to know how they would affect human fetuses.

Botox falls under category C, and Kelly Culwell, a board-certified OB/GYN and women's health expert, told Byrdie, "In general, category C means the benefits to the woman need to outweigh the potential risk to the fetus in order to recommend use of the medication." Dr. Culwell added that there are always potential risks involved when using drugs under category C. She doesn't think it's a good or safe idea to use Botox during pregnancy "for cosmetic purposes" and also recommends avoiding it during breastfeeding as there is always a possibility for "some small amounts of the toxin to pass through breast milk."